15 comments:

Recently I was unfortunate enough to have to search for physicians in my area... hopeless. There are a number of referreal / rating sites, but even the pay sites will only get minimum data: education, licence, any administrative action ..etc. There really isn't a way to get any qualitative data, "patient ratings". Healthia clearly looks nicer, the maps are helful ..etc, but how will it overcome the lack of content / patient review problem?

What about offering (the best-rated) doctors the opportunity to post something up in their clinic that says 2005 Healthia rated ____ once the site has reached a good mass? Zagat is so successful because it's associated with all of the "good" entertainment venues, not because it alerts you to the "bad."

You make a good point about Zagat. Others have taken a propreitary approach to rating doctors, we will continue to look at working with them.

Our approach however is basically different - we seek to leverage the power of the online community to help itself. We do not rate doctors, we make objective information available and known and allow users to search for and rate doctors according to their preferred criterea.

Clearly, this approach will take longer to pay dividends but our hope is that we can build a resource that would be truly unique and valuable.

I'm a flight attendant and must occasionally look for a medical referral while traveling. I checked out this site using a few variable cities (where I have layovers) and found some good information -- although I hope that I never have to use it.

I'm going to include this info in a post on my blog as I think others will find it equally helpful.

I work as a doctor and one great part of it is meeting people and being able to translate medical jargon for them so they can be empowered over their situation and aware of all their options. According to most of my patients, I'm a reasonably caring and interactive doctor. However, stuff like this website has definitely made me want to leave the profession at an early age.

1/ Have you ever read the website "How to ask questions the smart way"? Replace the words "hacker" with "doctor" and "you" with "you as a patient". The number of times I've spent 30 to 120 minutes with a patient asking open-ended questions to figure out the problem, gently explaining the situation and trying my best to give useful, relevant answers in both technical and layperson's terms...only to hear the person say to the nurse or someone on their phone on their way out "nah, the doctor didn't really tell me anything" or relaying "the message" to people as their own distorted version of what they wanted to hear, not what's really going on... is probably 10 times more than any hacker has ever rolled their eyes and said "PEBCAK".

2/ At the moment I work 8 - 16 (that's not a typo) hour hospital shifts, often without having slept, eaten or even time to drink water regularly. Most clinic doctors are kind hearted and try to squeeze in patients who request being seen urgently, making their workload consistently 10-100% in excess of what's actually ideal. At the moment, there simply aren't enough saps out there who are willing and able to be doctors, so the rest of us work hard to pick up the slack, so yes, sometimes we're frazzled. Wouldn't you prefer someone who actually agrees to see you in a timely fashion, even if it means they have to spend 5-10 minutes less with every patient that day, rather than just have their secretary say "no bookings until 6 months from now, see ya later".

3/ If someone rated you on every single 15 minute increment of your workday on how polite, professional and non-threatening you were acting don't you think at least one person at random could write a scathing report about how abrupt, snappy and frazzled you seemed at that time and suggest people take their business elsewhere? Now skip all your meal breaks, turn up an hour or two early, leave an hour or two late, ask someone in your workplace to vomit, cough up phlegm or smear their blood on you, your desk and shoes and ask yourself the same question.

4/ Personally, if I need surgery, I'd rather have the most socially inept surgeon who's done thousands of the same operation that year (and thus doesn't really have time to talk to me in his clinic) than the nice, friendly chap who spends all day talking to me and making friends with me but only does two or three of the same operation in a year.

I agree with the website in principle, it is hard to find a doctor that you get along with initially but the temptation for people to simply "vent" is a bit full-on. There's also a lot to be said for technical proficiency. I hope it's closely moderated! Are the doctors themselves able to respond to the claims on the site?

You raise important concerns about the inevitable rise of consumer scrutiny in medicine. Philosophically you and I agree that in general the benefits outweigh the costs of transparency, so long as there are mechanisms of fairness and editorial control at work.

Specifically, I do have some responses to your questions, point by point.

1/ To the extent that people misjudge your intentions and capabilities, more sharing of data will ultimately serve you. One loudmouthed idiot will be quickly marginalized in a sea of grateful patients.

2/ I think you are actually mistaken about the preference of your customers... I for one would actually prefer to hear that a doctor is unavailable for 6 months, and instead find a different one, than to be rushed. Squeezing me into your busy schedule is NOT the favor you seem to think it is.

3/ Hey, life sometimes sucks for everybody--and your patients are usually having a worse day than you. I agree that bedside manner isn't my number one criterion for picking a doctor, but on the margin it makes a difference.

4/ Sure, if you're clearly the best, most experienced doctor in the world, your patients and prospective patients shouldn't and probably wouldn't sweat the other details. And more data available on the internet will highlight those elite 10%. Now as for the other 90% of doctors, maybe they ought to spruce up their waiting rooms!

Since you asked, Healthia certainly plans to accommodate doctors who wish to rebut reviews, though honestly I don't think that feature is yet enabled.

You raise a much bigger problem when a presumably good doctor like you seriously considers quitting. As you point out, medicine is an increasingly thankless profession. However, I believe that market dynamics will, in the long run, prevail upon talented students to pursue this career, once consumers are able to make their own decisions. Many of us choose to pay extraordinary premiums to retain the very best teachers, lawyers, veterinarians, accountants, clergy (whatever "best" means for them), even "hair stylists". Don't you think that in a free market, the best doctors will once again command the kind of compensation that attracts the very best?

Thank you for your post. You raise some important questions. In addition to David's response, I'd encourage you to give us actionable feedback that improves the quality of comments we obtain at the site:

1. We are considering replacing the comments section with a pros and cons section that would encourage users to be thoughtful (versus emotional). What do you think of this?

2. Are there other user discernable crieterea you would recommend we add to our survey?

3. Do you have suggestions for an easy and simple way we could authenticate doctors who wish to respond to reviews?

4. What sorts of feedback would doctors want to hear from their patients?

Hi chiniWhat sorts of feedback would doctors want to hear from their patients?

If patients prefer receiving information directly from their physicians, would they not also prefer to access the physicians' Websites? Cyber Dialogue's surveys indicate that they would. More than a quarter of the Internet users who express an interest in doctor Websites indicate that they would be likely to switch doctors to do so. O'Connor and Johanson find that 25% of surveyed clinic patients have searched the Web for health information in the past twelve months and that 60% intend to use the Web in the future. Based on these findings, O'Connor and Johanson urge fellow physicians to create their own Websites, use the Web for patient-education information, and help patients to evaluate the information on the Web. This is a common thread in articles and surveys regarding the opportunities that still exist for physicians to establish an electronic presence in their patients' lives. These opportunities for physicians also represent opportunities for librarians to lend their expertise to the process. In this way, as the model for physician-patient relations shifts toward collaborating and shared decision making, librarians can assume similar collaborative roles with both physicians and patients.

I just found this website and I think it's great. I have been to SO many doctors and come out of the appointment SOOO frustrated that I was looking for a review of a doctor before I go to another one.

I have some comments about Dea's post also...

1-As far as spending 30-120 minutes, I have never had a doctor spend more than about 10 minutes with me. And only about 1 minute of that is me talking. You have about 3 sentences to say before the doctor obviously zones you out and starts talking. Things can be complicated and sometimes it takes us patients a little more time tell doctors about our medical problems.

Another thing.... not to be rude, but it's your *job* to ask open-ended questions to try figure out what's going on. We shouldn't have to think of how to ask the most perfect, smartest question. YOU'RE the one we're paying, YOU'RE the one that went to medical school, so it's YOUR job. All we know is that we're sick and miserable.

2- You know, the fact that you have to work a lot of hours and don't have time to sleep, eat, whatever is not my fault, so don't take it out on me as a patient. Everybody has a hard life. Being sick isn't so great either. You knew what you were getting into when you became a doctor, so just deal with it. Otherwise get out of the doctoring business.

3- Again, that's your JOB. It's up to you to figure out how to be nice and at least act a little compassionate to each and every patient you see.

And I agree with the David guy... no, I HATE being "squeezed" into a 10 minute slot. All the doctors to is listen to you for about 2 seconds and then throw a few prescriptions at you and their out the door. It's horrible. I can't tell you the number of times that I got in my car after a doctor visit and just cried and cried because it took so much time and effort to get their, fill out all the paperwork, wait and wait, and then I didn't even get all my concerns addressed.

I don't mean to insult you directly. I realize this is not all the doctors fault, that it is more of the "System's" fault. Our health system is totally ridiculous.

Anyway, I would highly endorse any website that offered doctor reviews. And letting the doctors rebut a review is fine with me. Might clear up some misunderstandings that can't be addressed in a 10 minute visit....

I am going to post comments here-only because as a Physician Recruiter, I work with Physician on a different level. I work with them when they are looking to present themselves at their best because they are looking for employment, $$$ and have family concerns. Many of the doctors I work with are here on visa status and are not even US citizens and the experience is very interesting to say the least. I think beyond their medical skills, we as consumers and as US citizens should know what is motivates them.

Anonymous, I have nothing against the website and it may be a good idea, who knows.But the rest of your opinion troubled me.

Medicine in US has turned into strictly business, about demand of patients and insurance companies, and the physicians to fulfill it. It is sad, because it is not business, at least it should not be mostly business. It is compassionate service that physicians try to give to help their fellow human, using their best and evolving knowledge and skills.Now, I am not saying there are no business-minded physicians out there, but not all of us, and certainly not me.

Sixty to eighty percent of US physicians have experienced burn-out sometime in their career and have thought about leaving the clinical field at least one time in their life. Imagine if that should happen. The small number of the physicians left behind would have even less time for you, be more overworked that they are probably will be less compassionate, more grumpy, etc.

And what places that are short of doctor do? They try to lure physicians (mostly newly graduate) with more money and benefits. Now, very few people will say no to that, but to meet the expected productivity for the salary and benefit, the physicians are required to see anywhere from 26 to 35 patient in a stretch of 8 hour daily. Hence, you only got 10-15 minute each. Also because, in between patients, we have to do the paperwork that your insurance company or you or somebody else requested from us, refill of medications, answer phone calls, etc. Some of us have to take care of patient in the hospital too at the same time.

It may sound and look likes a prestige and filled-with-money profession, but if I have a chance to do it all over again, I probably would not. Sadly it is not that easy to find a non-clinical job out there.

I know this is nothing compare to the pain, stress and despair that you have because of your sickness. We know that. That’s also why we continue to do it, because, some of us still have conscience. I am grateful for that, cause one day I would be a patient too.

Anonymous

BTW, without the foreign-physician with visa here in USA, all the city and state will practically be short of doctors!!!

Compassionate doctor is definitely an oxymoron, at least where I live. Some of the Dr's probably are thinking how could she know that? Because I'm an RN and have talked to all of them at one time or another. Now that I'm a patient and unable to work because "doctors" wouldn't think that maybe their patient or family members have vital information that could help them diagnose their patients. But alas, we are a group of hypochondriacs or drug seekers. They have already sized you up 30 seconds after they step foot in the room, and once that happens nothing changes their mind. I would have been diagnosed 15 years earlier with my disease had 1 doctor listened. I had to travel 200 miles to finally find out what was wrong with me. Unfortunately so much damage was done to my body at that point that my life span has been severely cut short Now I see a Dr. once a month, he walks in says hey girl, how's it goin? and hands me the prescriptions before I can say anything, and that's how he wants it. When I told him my O2 sats were still in the 80's after my surgery, he said "ahh thats nothing, I saw a guy who had sats in the 50's this morning". Most likely The guy was in the morgue by the afternoon. I live in Montgomery Alabama and see no hope of anything better than what I have right now. To me and other patients in the richest country in the world that's sad. This is the best we can expect? I've literally given up. By the Way I did find 1 compassionate surgeon who happened to be a surgeon and had done thousands of the same surgeries a year(that's for Dea). How did she get that way, she suffered from the same illness and as a patient was treated the same way I was. I do care if the doctor doesn't care about his or her patients if they are operating on me, because if there is a mistake it's not an easy come, easy go attitude.

These sites are becoming popular because doctors have not provided the self governing scrutiny necessary to improve poor healthcare providors services. I can't blame them really, who wouldn't like to be held unaccountable for their whole career. Staff HealthcareReviews.com

How about a DESPERATELY NEEDED WEBSITE that recommends only the NON-OPIOPHOBIC doctors?!

I am a CP patient (Chronic Pain) and have Y-E-T to find a doctor that will adequately treat my pain with medication!!!!! In fact, several millions of us are UNDER-prescribed! And a growing number of those go on to "off" themselves, as a last "pain management" resort!!

The need for doctors that prescribe what the PATIENT'S idea of a medication (and ENOUGH of it!) works for THEM is TREMENDOUS! When I first got recommended to PM (Pain Mgt) I thought I was finally going to be relieved. DIDNT HAPPEN. At least not for very long. As 'their' idea and 'my' idea of adequate pain relief obviously DIFFERED! So I am on my 3rd of 4th Pain Mgmt clinic now, and in search of yet ANOTHER one! 'Maybe' someday I will find a doctor that will actually script me enough to get me THROUGH the month until my next appointment!!!!! And a doctor that wont demand that I have invasive procedures before they continue to treat me with medication, when pain meds ALONE work FINE for me at this point!!!!!

For the love of G-d, this ridiculous UNDERPRESCRIBING has GOT to stop!! What about the PATIENTS rights to living as quality a life as possible? My 'quality' of life is still affected by ongoing, undertreated PAIN!!! >:(

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